Antimicrobial Prophylaxis in Surgery

Antimicrobial prophylaxis can decrease the incidence of infection, particularly wound infection after certain operation, but this benefit must be weighed against cost, risks of toxic or allergic reactions, and emergence of resistant bacteria. The administration of antibiotic agents to prevent infection cannot be substituted for Surgical wounds may be designated as clean, contaminated, or dirty, as described below:


  1. Clean Wounds

Chemoprophylaxis has no place in clean operative procedures.


Contaminated wounds

This category includes operations involving, for example, the interior of respiratory, urinary, or gastrointestinal tracts. NB:Chemoprophylaxis may be useful in such situations.


Dirty wounds

These include most traumatic wounds, which are highly contaminated. In such situations, a thorough surgical toileting is necessary,apart from chemoprophylaxis. Other tightly contaminated wounds involve operations on the large intestines and severe burns.


Did you know?: Other risk factors in the development of infection include the development of infection secondary to malnutrition,impoverished blood supply, obesity, old age,and immunodeficiency states.


These include the following:

  1. Operative procedures of long duration, such as cardiac and vascular procedures, orthopaedic, and neurosurgical procedures.
  2. In clean surgeries for insertion of a prosthesis or graft material.



  1. A single dose of parenteral antimicrobial given with induction of anaesthesia before an operation usually provides adequate tissue concentrations for several hours.
  2. Or 3 doses cover of the same antibiotic for 24 hours.

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